WASHINGTON – Eight states and the District of Columbia don’t have
laws that specifically bar insurance companies from using domestic
violence as a pre-existing condition to deny health coverage, according
to a study from the National Women’s Law Center.
The states are
Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South
Carolina, South Dakota and Wyoming. The study by the nonpartisan,
nonprofit center focused on individual coverage, not group coverage.
Some
of the states, particularly North Carolina, argue that other statutes
on their books address the issue.
At least one of the health care
bills circulating in Congress includes a specific federal prohibition on
the use of domestic violence as a pre-existing condition. Other bills
include blanket bans on pre-existing conditions.
Though domestic violence as a pre-existing condition isn’t thought to
be as widespread as it once was, lawmakers say it’s yet another example
of the need to overhaul the health care system.
‘THE
BOTTOM LINE’
“This is insane,”
said Sen. Patty Murray, D-Wash., who’s been trying to convince Congress
to address the issue for roughly a decade.
Murray said she
couldn’t remember exactly when she first learned of it, but sometime in
the 1990s she recalls a private conversation she had with a woman who
broke down as she explained that she couldn’t flee an abusive
relationship because her children were covered under her husband’s
health care plan and she couldn’t get her own. Another woman told Murray
that she didn’t report that she’d been battered because she feared
losing her coverage.
“It infuriates me an insurance executive can
sit in his safe world and decide how to make money,” Murray said. “For
them it’s all about the bottom line. Abused women don’t have a voice.”
First
lady Michelle Obama also took note, saying in a speech last month that
insurance companies continue to practice gender discrimination.
Much
of the evidence that domestic violence has been a factor in denying
coverage is dated.
An informal survey by the House Judiciary
Committee in 1994 found that half of the 16 largest insurers in the
country considered domestic violence in deciding whether to approve
health coverage. The Pennsylvania Insurance Department reported a year
or so later that nearly 1 of 4 insurance companies factored in domestic
violence when deciding whether to issue or renew policies.
Lisa
Codispoti, senior counsel for the National Women’s Law Center, said it
was hard to know whether insurance companies had changed because they
closely guarded their underwriting standards, and battered women had
always been reluctant to speak out publicly.
“We don’t know how
many insurance companies still have that policy,” she said, “but we are
talking about an industry that once charged a race-based premium.”
Codispoti
said that while insurance companies didn’t mention domestic violence
outright in health policy applications, they could piece it together
from such things as medical records.
ANECDOTAL
EVIDENCE
A spokesman for an
insurance industry trade group, Robert Zirkelbach, said he wasn’t aware
of any companies that used domestic violence as a pre-existing
condition.
“We believe strongly that no one should be denied
coverage because they are victims of domestic violence,” he said. Yet
Murray and others said there was plenty of anecdotal evidence to suggest
that the practice continued.
“We know there are abuses,” said
Kansas Insurance Commissioner Sandy Praeger, who heads a health care
task force for the National Association of Insurance Commissioners. Many
states have adopted a model law written by the association that
prohibits the denial of health insurance because of domestic abuse or
other pre-existing conditions.
“We don’t develop models unless
there is a need,” Praeger said. “It’s not a huge problem, but it got the
commissioners’ attention.”
North Carolina feels it was unfairly
singled out in the study last fall from the National Women’s Law Center.
“We
certainly don’t allow domestic violence to be used as a pre-existing
condition,” said Kristin Milam, a spokeswoman for the North Carolina
Insurance Commissioner’s Office. Milam said domestic violence as a
pre-existing condition was specifically banned in a statute for group
coverage and that a broader statute for individual policies also barred
it, though not by name.
Codispoti said, however, that the North
Carolina statute that covered individual policies “at best is not clear.
We don’t read it that way.”
On Capitol Hill, Republican aides
privately dismiss that flap as a “red herring” drummed up by liberal
bloggers.
“Tell that to a woman who has faced this,” Murray said.
The
issue was first reported by The Huffington Post.
Murray remembers
three years ago when the then-Republican-controlled Senate Health,
Education, Labor and Pensions Committee blocked her effort to impose a
federal prohibition on a 10-10 vote. All 10 who voted against her
amendment were Republicans.
“Clearly, the insurance industry
influenced that vote,” Murray charged.
The Republicans who voted
against the measure had received nearly $6 million in campaign
contributions from insurance companies, health care providers, the
pharmaceutical industry and health care product manufacturers in the
years leading up the vote, according to the Center for Responsive
Politics, a nonpartisan group that tracks campaign contributions.
– Tri-City Herald
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